Driving quality to improve
patient experience
By Pat Ford, Deputy Chief Nurse and Sue
Venables, Communications, Engagement
and Involvement Manager
Scope of the workshop
In this workshop we will answer the following questions:
What is Quality in the NHS?
Who in the CCG undertakes the Quality functions?
How do we ensure Quality of our commissioned services?
What are the current Quality concerns and what are we doing to about
these?
• How are we are keeping people safe?
• How we are ensuring clinical effectiveness?
• How are we using Experienced Led Commissioning to co-design
services: WLCCG Care Homes Project
•
•
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What is Quality in the NHS?
We have a single common definition of quality that
encompasses three equally important parts:
Care that is SAFE
Care that is
CLINICALLY
EFFECTIVE
Care that provides a
POSTITIVE
EXPERIENCE
Putting patient experience at the centre
everything we do
Meet the Quality Team
How do we ensure quality of our services?
Proactively
monitor
quality
Drive
continuous
quality
improvement
React
responsively
to quality
concerns
Quality Assurance Mechanisms
• Hold Providers to account
• Monthly Contract Quality
Reviews
• Quality Dashboards
• Deep Dives/Themes
Reviews
• Quality Visits
Provider
Level
• Contract Performance Monitoring
GP Issues Log
•
Serious Incidents Group
Pati
Safety Reports
•
Safeguarding Reports
•
Patient Experience
CCG Internal
Reports
Reports/Complaints
•
• Audit Co
Other
Stakeholders
• QSG
• Risk Summits
• Quality Networks and
Forums
External
•
NHSE
• CQC, HWBB, TDA, NHSE!,
HSCOSP
Ongoing mechanisms for engagement
Listening
booth
Mystery
shopper
Patient
leaders
Partnership
working e.g.
Healthwatch
VAL, VASL
Campaigns
- Health
Bus
Staff survey
and
engagement –
CCG
Experience Led
Commissioning
PPGs
Patient
mailing list
Deep
dives
Social
media
Current Quality Concerns
Staffing shortages across a
range of providers
Remedial Action Plans (RAP)
Monthly staffing metrics
CQC Regulations issued to
UHL and EMAS
Monthly Oversight Meetings
RAP
Waiting time delays in Urgent
Care Provider organisations
Monitoring incidents and
serious incidents
Waiting List delays in UHL
Contract Query
Root Cause Analysis
RAP
Increase in number of pressure
ulcers in UHL and LPT
Quality Visit Schedule:
Thematic Review
How are we keeping people safe?
Care that is SAFE
Care that is
CLINICALLY
EFFECTIVE
Care that provides a
POSTITIVE
EXPERIENCE
Care and Treatment Reviews
Need to ensure our people with Learning
Disability and/or Autism who are
currently in inpatient services are safe
and feel safe, and wherever possible can
be transferred to community settings.
We developed processes and systems to
ensure we meet the NHSE requirement.
Chief Nurse and Deputy Chief Nurse
chair the panels that consist of “Expert
Clinicians” and “Experts by Experience”.
Court of protection
Need to ensure people who have
Continuing Health Care and who are
deprived of their liberty in the community
have least restrictive practice applied
and Best Interest Decisions have been
made to comply with legal requirements
We apply what is called the ‘acid test” in
deciding whether an incapacitated adult
is being deprived of their liberty
Is the person subject to continuous
supervision and control?
Is the person free to leave?
How are we ensuring clinical
effectiveness?
Care that is SAFE
Care that is
CLINICALLY
EFFECTIVE
Care that provides a
POSTITIVE
EXPERIENCE
Training and support to improve clinical
skills and patient care
Developed the LLR General Practice Nurse (GPN)
Strategy
Skill sharing to
improve care
Funding staff
training
Supporting our
practices
• Hold an annual
GPN and HCA
Conference
• Assistant
Practitioner
training places
• Advanced Nurse
Practitioner
training
• Pre-Registration
Nurse
Placement
• Nurse
revalidation
• Workforce
development
How are we ensuring positive
patient experience?
Care that is SAFE
Care that is
CLINICALLY
EFFECTIVE
Care that provides a
POSTITIVE
EXPERIENCE
Are we measuring what really matters?
“People crave a life not a service”
The care we provide is a means to
this end
• When you measure the wrong thing, you
get the wrong thing
• When you measure what actually
matters, good things happen
What is really driving the NHS?
Experience Led Commissioning
RESEARCH WITH LOCAL
PATIENTS (CURRENT SITUATION
AND WHAT MATTERS MOST)
EMBED INTO
CONTRACTS
WORK WITH
FAMILIES AND
FRONTLINE TEAMS
TO DESCRIBE ‘GOOD’
IN LOCAL PATHWAY
CO-DESIGNED WITH LOCAL
PEOPLE
AND LOCAL COMMISSIONERS
AND PROVIDERS
Experience Led Commissioning in Action
Everyone Counts
Long Term Conditions
Non-urgent patient transport
Hinckley community health
services review
Care homes review
ADD INFOGRAPHIC
Principles of ELC PCOM design:
ADD INFOGRAPHIC
Principles of ELC PCOM design:
ADD INFOGRAPHIC
Principles of ELC PCOM design:
Putting actions into practice
Supporting self care and
prevention
Working with two nursing homes
and two residential homes to
initially baseline current provision
and highlight gaps identified by
care home staff
Test more patient centred training
that can be provided flexibly to fit
around availability and needs of
care home staff
Putting actions into practice
Working with primary care
Providing a more multi speciality
provider approach and releasing
GP time for more complex cases
Explore providing proactive care
service currently provided in
patient’s own home in care
home setting
Thank you